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Health

Advanced technology, degraded trust: How the COVID-19 vaccine compares to historical precedents

Harlan Hatcher, Thomas Francis, Jonas Salk, and Basil O'Connor at Polio Vaccine announcement
University of Michigan News and Information Services Photographs, Bentley Historical Library
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Crowds cheered this weekend as the first doses of Pfizer’s COVID-19 vaccine rolled out of the production plant in Portage, Michigan. It was an emotional moment for some health care workers, too, as they became the first in the state to receive vaccinations. This historic step brings a cautious hope at the end of a devastating year. It also highlights how vaccine production has changed amid shifts in American science, medicine, and culture over the past several decades.

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“There has never been a faster process, from discovering a newly emerging infectious disease and getting it all the way to a workable and usable vaccine in basically under a year,” said Dr. Howard Markel, a physician and a medical historian at the University of Michigan.

The closest parallel to the scale and urgency of the COVID-19 vaccine development and distribution is the polio vaccine, which was announced in 1955 at the University of Michigan, Markel says. But, he adds, science, communication, and manufacturing have changed significantly over the years. When virologist and medical researcher Jonas Salk discovered the polio vaccine, he became a household name. But this time around, there’s no single individual leading the effort.

“Because the science was shared, and people were working around the world on this process, scientists in Germany or Israel or China or Russia, as well as the United States and so on, could all communicate and work with one another, from the point they discovered the actual genome of this virus, very early in the proceedings, to the point of today,” Markel said. “It wasn’t about being first and who gets the credit.”

That free flow of information, as well as significant advances in medical technology led to the fastest vaccine development in history. In contrast, Markel says, the polio vaccine development process took decades. While the first polio epidemic in the U.S. was in 1916, Markel says it wasn’t until 1938 that President Franklin D. Roosevelt founded the nonprofit National Foundation for Infantile Paralysis—which became known as the March of Dimes—to support polio patients and develop a vaccine. And though a vaccine was ready in 1954, a careful field trial—involving 1.8 million kids—was conducted before its rollout the following year.

The polio vaccine effort garnered broad support from the American public: everyday citizens gave what they could to help fund the March of Dimes’ work, Markel says. And, he adds, while Americans might have been especially inclined to support vaccine development because polio primarily affected children, that’s not the only difference between the polio and COVID-19 vaccine efforts.

“It was a different era, where there was much greater trust, less disinformation, less avenues for disinformation than this current vaccination process,” Markel said. “We already know that about half the country is against the COVID vaccine because of not only anti-vaxxer sentiment, but even political grounds. So there’s a real challenge with doctors, public health officials, government leaders, and others to get everyone vaccinated for COVID, because that is the only way we’re going to kill this violent enemy.”

The public’s trust in doctors and politicians in the 1950s even survived challenges in the polio vaccine manufacturing process, Markel says, including the infamous Cutter Incident. California’s Cutter Laboratories accidentally introduced live virus into a vaccine shipment. Tens of thousands of children got sick, more than 200 were paralyzed, and several died. The vaccine rollout was halted briefly, until public health leaders could introduce better quality controls, and then the mass vaccination of children continued, Markel says.

“Can you imagine if something like that happened today with COVID? It would stop everything dead in its tracks,” he said.

Today, while about six out of ten Americans say they would be willing to get a COVID-19 vaccine, some are, for a number of reasons, uncertain. Markel notes that in an era of heightened disinformation and politicization, particularly around inoculations, some are suspicious of the vaccine. And because they have experienced hundreds of years of racist medical abuse, Black Americans are particularly hesitant to trust in a medical system that has historically harmed them.

Markel says the multistep nature of the Pfizer vaccine—which requires two shots—could further hinder Americans from getting the vaccine. But, he says, it’s important for as many people in the U.S. as possible to roll up their sleeves and get vaccinated for COVID-19.

“This vaccine has been vetted carefully by the best minds in vaccine science, immunology, [and] infectious diseases in the world. These are careful men and women who are very well trained to do that,” he said. “While no biological entity is 100% safe, this one looks to be very, very safe, and it’s one I would give myself or my children.”

This post was written by Stateside production assistant Nell Ovitt.

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